Diabetics Served by the Medicare Competitive Bidding Program May Be at Risk

When the Competitive Bidding Program (CBP) was created as part of the Medicare Prescription Drug, Improvement, and Modernization Act, the goal was to reduce costs while providing quality care for beneficiaries. However, some say the program has failed on both accounts.

In 2011, the Centers for Medicare & Medicaid Services (CMS) established the CBP for diabetes supplies in nine markets. While CMS claimed that there were no changes in health outcomes for patients in these markets, a study recently published in Diabetes Care suggests otherwise. In fact, the data indicates that, in those nine markets, there was a 23% increase in diabetic patients receiving partial supplies or no supplies whatsoever. In non-CBP markets, the increase was only 1.7%1.

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In addition, George Grunberger, M.D., who is the president of the American Association of Clinical Endocrinologists (AACE), wrote to members of the Senate Finance Committee that the CBP has actually led to higher Medicare costs. He claimed that Medicare has used the CBP to save money by “restricting access to improved technology devices and limiting choice for patients….” The end result of this kind of savings, he added, “has been an increase in patient adverse events, including higher mortality rates and hospitalizations, which ironically have led to overall higher Medicare costs.”2

Prior to competitive bidding, patients used brand name blood glucose meters and test strips, which provided accurate readings. Since the switch to competitive bidding, patients in the affected markets now have to use lower quality devices that lack user instructions and often provide incorrect data. These inaccurate readings have led to adverse medical events.1

Numerous advocates are urging that the CBP be suspended for diabetic supplies until CMS can prove that patient health is not at risk. There is also growing support for H.R. 771, the Protecting Access to Diabetes Supplies Act of 2015.3 With the continued competitive pressure this program has placed on providers plus the increased health concerns to which diabetic patients have been subjected, the program doesn’t seem to be proving as beneficial as CMS promised, even for those it was intended to help.